From Activities to Outcomes: Elevating Medical Affairs as a Strategic Driver

In this interview, Christoph Bug, VP Global Medical Veeva, explains how Medical Affairs must evolve from tracking tasks to demonstrating impact on patient outcomes. He outlines the Veeva Pyramid, the need to define Medical Affairs’ role first, and practical examples showing how insights and patient-centric metrics can influence decisions across R&D, Commercial, and patient engagement. The discussion also touches on governance, scientific positioning, and the five‑year horizon for Medical Affairs as a science-guided, strategic function in pharma.

In exploring the risk of medical teams focusing on activities rather than outcomes. What’s the biggest danger, and how does this shift redefine Medical Affairs as a strategic function in a data era?

That’s why the Veeva Pyramid matters: it connects activities to enablers (like relationships, education, and insights) and ultimately to outcomes (scientific belief alignment, clinical practice change, and patient outcomes). The goal is to move from “we produced X” to “our actions improved Y for patients,” which requires measuring impact across levels and using insights to drive strategic decisions, not just activity counts.

I see this as a practical blueprint. We must start by articulating a clear role for Medical Affairs, then map activities to enablers and to outcomes. We should combine quantitative measures with qualitative signals—audience engagement, knowledge gap closure, and shifts in stakeholder interpretations—to demonstrate a real-world impact. In this AI-enabled landscape, I also expect Medical Affairs to curate evidence and guide its translation into practice, ensuring insights drive policy and care, not just reports. This isn’t a cosmetic shift; it’s a fundamental realignment of how we define success, with patient outcomes as the ultimate yardstick and strategic influence as the reward for doing it right.

The Veeva Pyramid maps foundation activities to outcomes. How should organizations operationalize it, with concrete examples at each level to avoid misalignment?

I’d start with the foundation—effective activities—and then treat enablers as the bridge to impact. For relationships, I ask: are we engaging the right stakeholders, and are they well connected to us? For education, I assess whether our information closes knowledge gaps and evolves as new evidence emerges. For insights, I evaluate what the organization learns and whether that knowledge triggers strategic shifts. At the outcomes level, I consider scientific belief alignment: do we and stakeholders interpret evidence similarly? If not, that’s an opportunity to deepen dialogue and gather more data. Next, clinical practice change asks whether clinicians alter treatment decisions in light of the evidence. Finally, patient outcomes assess whether patients actually experience better health outcomes due to the correct therapy and timing. Practically, I’d use the pyramid diagnostically: if outcomes aren’t moving, diagnose misalignment, information gaps, or access to the right patients. And with AI rising, I’d ensure insights are timely, actionable, and integrated into decision-making, not buried in reports.

Moe: When you see variances in evidence interpretation, what should Medical Affairs do to address gaps and move toward alignment?

I’d first clarify the department’s explicit role and objective. Are we informing, aligning scientifically, changing practice, or improving outcomes? Once defined, I can frame metrics aligned to that role. Variances signal deeper questions: is there a knowledge gap? Do stakeholders interpret data differently? Do we need more evidence, different data categories, or broader engagement? I treat variances as diagnostic clues, not failures. I’d initiate a structured, open dialogue to understand the reasons, then adjust the evidence plan, perhaps broadening data collection or refining education. The scientific position—clearly stating how we interpret evidence and how the product should be used—becomes a valuable anchor, inviting corrective discussion rather than defensiveness and helping the organization converge on shared understanding.

From my vantage point, I’d also implement iterative cycles: publish interim interpretations, invite stakeholder feedback, and update the evidence plan accordingly. This keeps conversations productive and grounded in science, while enabling us to align on next steps. If overlaps exist with commercial or market access, I’d seek cross-functional governance to ensure interpretation remains evidence-based and compliant. The goal is to transform variance into informed convergence that strengthens practice and patient care, not into turf battles or stagnation.

Compliance is a core concern when measuring value. How can we pursue patient-centric objectives while staying within regulatory and governance constraints?

I’d start with explicit, measurable, governance-backed patient-centric objectives. Avoid tying goals to individual performance targets; frame them as function-wide objectives showing the delta between evidence-based reality and current practice. For example, if I believe 10,000 patients should receive a product, but only 5,000 do today, that delta becomes an organizational ambition. The essential point is to keep objectives patient-centered, evidence-based, and governed by transparent decision rights. Governance ensures we avoid personal incentives while maintaining compliance and pursuing improvements. I also advocate for a structured review process to confirm all measures, data sources, and analyses comply with regulations and internal policies before any public communication or internal decision.

I see a practical path through cross-functional alignment. Create a published, patient-centric target with senior oversight, document the evidence base, and maintain an audit trail of decisions and changes. This approach lets us pursue real-world impact without compromising integrity. It also supports regulators’ expectations for transparency and reproducibility in how we translate evidence into practice. In short, patient-centered ambitions plus robust governance equal a path to compliant, meaningful progress that aligns Medical Affairs with broader corporate goals and patient outcomes.

Can you share a concrete example of how measuring “the right patients on the right therapy” changed how Medical Affairs was viewed within a large pharma company?

A: I can share a notable example from a top-five pharma company. They defined a specific patient profile most likely to benefit from their product, quantified how many patients fit that profile, and measured how many actually received the therapy today. This created a clear, patient-centric ambition with a measurable target, reframing Medical Affairs as a driver of real-world impact rather than a disseminator of information. It also highlighted cross-functional alignment challenges—especially with Commercial—around translating evidence interpretations into shared business goals. The exercise surfaced value leakage, particularly in content used or ignored across regions, prompting a reallocation of resources toward more impactful, scientifically grounded activities. The result was a more patient-focused, data-driven approach that elevated Medical Affairs’ strategic importance and aligned the organization around patient outcomes.

For me, the lesson is that measurable patient impact, when anchored in a transparent evidence base, can shift perception and increase influence. It demonstrates how Medical Affairs can shape strategy with science, improve allocation of content and resources, and drive cross-functional collaboration toward a common goal: delivering the right therapy to the right patients at the right time.

How are Medical Affairs insights shaping decisions across R&D, Commercial, and Patient Engagement today, and where do gaps remain?

I see insights as a core, cross-functional asset. Organizations capture insights in varied systems, but analysis and timely surfacing remain challenges. Insights inform scientific communications, expose knowledge gaps, influence commercial strategy, and guide patient engagement. They also touch clinical operations, revealing recruitment barriers and site-level challenges. My observation is that 40–50% of Medical Affairs insights relate to recruitment issues, making them invaluable to Clinical Operations. The gap is in analytics: we need tools that surface the right insights to the right people at the right time. We’re addressing this by expanding solutions to include commercial and clinical insights, enabling faster, data-driven cross-functional action. I believe the goal is to move from siloed data to integrated intelligence that informs strategy, execution, and patient care.

In practice, I’d push for standardized, auditable processes to capture, harmonize, and analyze insights across functions. That means cross-functional governance on what constitutes a meaningful insight, how it’s validated, and how it’s prioritized for action. We also need real-time dashboards and AI-assisted signal detection to surface patterns—like recruitment bottlenecks across sites—so teams can respond rapidly. If we can link insights to measurable actions and patient outcomes, we’ll demonstrate clearly how Medical Affairs adds value across R&D, Commercial, and Patient Engagement, not just as a compiler of notes but as a strategic engine for care improvement.

Looking five years ahead, how should regulators and boards define Medical Affairs value, given the push for patient-centric science?

I’m optimistic that Medical Affairs will take a more strategic, science-driven role. Regulators will expect a transparent demonstration of how medical insights influence care and how evidence guides practice. I also think we’ll see a shift away from commercial-dominated spend toward evidence-based, patient-centric investments. For instance, significant content spend—about 70% rarely used—signals value leakage; Medical Affairs can rebalance toward high-impact, scientifically grounded programs that meaningfully affect patient care. In governance terms, boards will want clear metrics linking Medical Affairs activity to patient outcomes, with robust risk management and compliance frameworks. The outcome is a more strategic, accountable function that shapes product development, scientific communication, and implementation to improve patients’ lives.

From my vantage point, five years hence, I expect Medical Affairs to wield greater influence by demonstrating impact across the care continuum. Regulators will reward transparency, rigorous interpretation of evidence, and patient-centric decision-making. The sector will view Medical Affairs as a core driver of strategy, not a supporting function; boards will require show-me impact on outcomes and patient benefit, and Medical Affairs will respond with measurable, governance-backed programs that align science with care.

Do you have any final guidance for leaders navigating this shift toward outcomes-driven Medical Affairs?

My core message is simple: medicine should steer our operations. I see Medical Affairs becoming a strategic, science-forward engine that guides development, communication, and clinical implementation to improve patient outcomes. To realize this, leaders must clearly define Medical Affairs’ role, choose the right metrics, and govern with patient-centric, compliant practices. It’s not a minor adjustment; it’s a transformation that requires cross-functional alignment, investment in insights capabilities, and disciplined execution. The industry is already moving in this direction, and those who lead with science and patient outcomes will set the standard for how pharma creates value in the years ahead.

I’d add one practical note: prioritize diagnostic use of the Veeva Pyramid to identify where you’re failing to translate evidence into care. Start with accurate patient definitions, measure the right outcomes, and build governance that keeps compliance intact while enabling ambitious, patient-centered goals. If we stay anchored in patient impact and rigorous science, we’ll earn boardroom respect, regulator trust, and—most importantly—better treatment for patients.

This interview is sponsored by Veeva.